Drug Resistance

• I have almost complete resistance to NRTIs (nucleoside reverse transcriptase inhibitors) and first-line NNRTIs (non-nucleoside reverse transcriptase inhibitors), and partial resistance to protease inhibitors. What are my options?
• I began HIV meds about 17 years ago. My resistance tests show that I am resistant to all protease inhibitors except Prezista (darunavir) and all NRTIs except Viread (tenofovir). My doctor put me on Norvir (ritonavir), Prezista, Isentress (raltegravir) and Atripla (efavirenz/tenofovir/FTC). Am I getting near the end of the road in terms of my options?
• I am one of those "forgotten patients" whose HIV is resistant to many meds -- even Isentress (raltegravir). I feel like the few of us left with multidrug-resistant HIV are going to be forgotten and die without help. What are the U.S. Food and Drug Administration and AIDS researchers doing for us, the forgotten few?
• I was recently diagnosed with HIV and had resistance testing done. The results show that, out of 19 different HIV meds, I'm already resistant to two of them: Sustiva (Stocrin, efavirenz) and Viramune (nevirapine). How can this be possible if I've never taken any HIV meds, let alone those two?
• I was infected with a strain of HIV that's resistant to the three major classes of HIV meds. My doctor has proposed a bunch of new medications and short-term use of Fuzeon (enfuvirtide, T-20) -- for only six months. Would stopping Fuzeon after six months make me develop resistance to it?
• I recently started taking Combivir (AZT/3TC) and Sustiva (efavirenz, Stocrin). However, I just learned that I have the M184V mutation, which indicates resistance to 3TC (lamivudine), a component of Combivir. I can't switch meds for another week because I'm working abroad and don't have access to HIV meds here. Will my 3TC (lamivudine) resistance make me resistant to Sustiva also, before I am able to change my regimen?
• After 12 years of HIV treatment, I have become resistant to some protease inhibitors, all NNRTIs and nearly all NRTIs. For the last year I've been taking Epzicom (abacavir/3TC, Kivexa) alone. I know that's not a good long-term strategy, but I seem to have few options. How can I find a drug combo that's effective and resistance-proof?
• I'm highly drug resistant, and my doctor just started me on a new, unproven drug regimen. If I become resistant to one or more of these new drugs too, what's next for me?
• I've heard that even if you are resistant to an HIV drug, that drug might still have some effectiveness. Is that true? Is drug resistance a matter of degree?
• I'm resistant to almost all HIV meds. However with two newly approved drugs, I was able to get my viral load below 200. Is that good enough or should I be striving to become undetectable?
• My HIV drug resistance test found no resistance to NRTIs or NNRTIs, but it did list a handful of "other mutations." What do these mutations mean?
• Does my decreasing CD4 count mean that I'm becoming resistant to my meds, even though my viral load is still undetectable?
• I stopped taking HIV meds almost two years ago, but now I need to restart treatment. An old resistance test showed resistance to a good number of meds. What are my options now?
• I'm highly resistant to all currently available HIV meds. Would any meds from my old regimens be effective if I started taking them again?
• If a phenotypic resistance test says that I have "complete" resistance to an HIV medication, what does that mean?
• If I stay 100 percent adherent to my HIV meds, can I avoid resistance, or will it inevitably develop at some point?

Switching Treatment

• What are good HIV meds to change to in order to decrease my risk of another heart attack?
• Two months ago, my doctor had me switch to a new regimen containing six HIV meds, including two drugs I have resistance to. Before I started this new drug combo, my viral load was undetectable, and it still is now. My CD4 count has also gone up a bit. Why does my doctor have me take meds I'm resistant to?
• I am resistant to NRTIs (nucleoside reverse transcriptase inhibitors) and I've never taken a protease inhibitor or NNRTI (non-nucleoside reverse transcriptase inhibitor). My doctor wants me to try a new regimen consisting of Atripla (efavirenz/tenofovir/FTC), Selzentry (maraviroc, Celsentri) and Isentress (raltegravir). Is this a good combo for me?
• I'm planning to get rid of the protease inhibitors in my current regimen, and will replace them with the NNRTI Intelence (etravirine). However, I have drug resistance to the older NNRTIs. Does this switch still sound like a good plan?
• I've been taking Sustiva (efavirenz, Stocrin) for the past four years, even though I have resistance to it, because there weren't any other options for me. Could I replace the Sustiva in my regimen with Intelence? What other options do I have?
• I've tried several different HIV regimens for about 20 years. My viral load consistently hovers around 1,000. I'm worried I may have developed resistance to a lot of HIV meds. How do I decide which HIV meds to try next?
• My viral load seems to be increasing. I have resistance to some HIV meds and am about to switch to a new regimen. Is it realistic for me to reach an undetectable viral load again?
• I'm already resistant to a few HIV meds, and now my doc wants to switch me off of Fuzeon (enfuvirtide, T-20), which is keeping my viral load undetectable, to "save" it for later. Is this a good idea?
• My doctor has told me to discontinue using a fourth HIV drug because my CD4 count has risen to a healthy level and my viral load is now undetectable. Will I still be able to use this drug in the future?
• I'm currently taking four HIV drugs, and I want to switch to the three-drug combo pill Atripla. My doc doesn't think it's a good idea because my resistance tests keep coming back inconclusive. What do you think? Can I safely switch meds?
• I haven't missed a single dose since I started meds three months ago, but I'm being told I have "fossils" of resistance to some meds. What does this mean? Do I need to switch meds?

Stopping Treatment

• I want to stop taking my meds -- Truvada (tenofovir/FTC) and Viramune (nevirapine) -- but my doctors don't agree on the proper way for me to stop. How can I limit my chances of developing resistance when I stop taking my meds?
• Even though I have an undetectable viral load, I know my HIV is resistant to some of the meds I'm currently taking. Is it safe to drop those meds out of my regimen and just keep the ones my HIV isn't resistant to?
• Ever since I stopped treatment, my CD4 count has continuously risen. And after an initial spike, my viral load has begun to decrease. How unusual is this?
• I've been off HIV meds for seven months because I'm resistant to everything. What can I do to stay healthy until a new drug regimen becomes available for me?
• I've been on meds since 1990 and want to take a break. When I asked my doctor about it, he said I'd be dead within a year if I stopped treatment. Is that true?
• I've decided to stop HIV treatment because meds have failed to get my viral load to undetectable and I can't stand the side effects any more. What do you think of this decision?
• Three months ago I stopped taking my HIV meds because of the side effects, and I feel better than I have in a long time. However my CD4 count has dropped rapidly. What should I do?

Resistance and Pregnancy

• I'm resistant to almost every HIV medication except Kaletra (lopinavir/ritonavir). I want to have a child someday; are there any HIV meds that are safe for me to use during pregnancy?

HIV/HAART Complications

• Even though I've been dealing with persistent diarrhea for over nine months, my doctor doesn't want to change my med regimen. What should I do?
• None of my problems -- depression, Fanconi Syndrome (a kidney disorder), major balance problems, etc. -- are officially associated with AIDS, but could they be caused by long-term effects of HIV and HIV meds?

For frequently asked questions on other HIV/AIDS topics, click here.